Successful transseptal puncture for radiofrequency ablation of left atrial tachycardia after closure of secundum atrial septal defect with Amplatzer septal occluder

We report on a 37-year-old woman presenting with atrial arrhythmias after catheter closure of a secundum atrial septal defect with an Amplatzer septal occluder device. Electrophysiological studies suggested that the arrhythmia originated from the left atrium, from an area near the device. Transseptal puncture was successfully performed under transoesophageal guidance and the arrhythmia was successfully ablated. This case showed that transseptal puncture can be safely performed in the presence of an Amplatzer septal occluder device under transoesophageal echocardiography guidance and we speculate that the device may have created the substrate for the arrhythmia.